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J Korean Bal Soc > Volume 2(1); 2003 > Article
Journal of the Korean Balance Society 2003;2(1): 121-126.
정상고막소견을 보인 소아어지러움증의 다양한 원인
정연훈, 유상준, 조민정, 문성균, 박기현
아주대학교 의과대학 이비인후과학교실
Various Causes of Vertigo in Children with Normal Eardrums
Yun Hoon Choung, Sang Jun Ryu, Min Jung Cho, Sung Kyun Moon, Keehyun Park
Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea. yhc@ajou.ac.kr
ABSTRACT
Background and Objectives:   The differential diagnosis of vertigo in children is extensive. Otitis media and middle ear effusion could be most common causes of vertigo in children, but there are some problems in detecting the other causes for vertigo because they are one of most popular diseases in childhood. The purpose of this study is to review the clinical characteristics and both the audiological and vestibular findings of vertigo in children with normal eardrums, who do not show otitis media or middle ear effusion, and assist in making a differential diagnosis of vertigo.
Materials and Method:   The sixty eight children (less than 16 years old) with vertigo, who visited the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 1995 and April 2003 were selected for this study. These excluded the patients with abnormal eardrums/tympanograms or those that did not perform questionnaires, audiological, or vestibular evaluations. They were retrospectively analyzed for clinical symptoms, audiograms, vestibular functions, and differential diagnosis.
Results:   The most common causes for vertigo in children were benign paroxysmal vertigo of childhood (BPVC) in 21 (30.9%) and migraine in 20 (29.4%). Other less frequent causes included four cases of trauma, three cases of acute vestibular neuritis. two cases each of Meniere's disease, delayed endolymphatic hydrops, benign positional vertigo, and one case only for cerebellopontine angle tumor, seizure, juvenile rheumatoid arthritis, leaving eleven cases (16.2%) as unclassified. Abnormal findings were noted in 14 (20.6%) in pure tone audiogram, 3 (4.4%) in positioning test, 11 (16.2%) in bithermal caloric test, and 47 (69.1%) in rotation chair test.
Conclusions:   The vertigo in children with normal eardrums, who did not show otitis media or middle ear effusion, was most commonly caused by BPVC and migraine. These findings have shown to be very different from those with adult vertigo. The evaluation of vertigo in children requires a questionnaire for extensive and complete history taking, audiograms and vestibular function tests. And in selected cases, electroencephalography, hematological evaluation, imaging of the brain or temporal bone should be performed.
Keywords: Vertigo; Child; Vestibular Function test; Audiometry.Middle Ear Effusion
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